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Standardized Patients at the NBOME

Standardized patients (SPs) are used in a variety of ways in medical education to provide student doctors with valuable hands-on clinical experience. At the NBOME, SPs are essential to assessing the clinical skills of medical students training to be licensed as doctors of osteopathic medicine (DOs).

Our SPs are carefully trained to portray a patient during a mock doctor-patient encounter as part of our administration of the COMLEX-USA Level 2-Performance Evaluation (Level 2-PE). This is the clinical skills component of our multi-level COMLEX-USA examination series, and every osteopathic medical student in the United States must take and pass the complete exam series to become a licensed osteopathic physician.

After the simulated exam, SPs document the events of the encounter, which takes place at one of our National Centers for Clinical Skills Testing—NCCST-Philadelphia (in Conshohocken outside of Philadelphia) and NCCST-Chicago (in the Rosemont area). Both are accessible by regional rail line. Free onsite parking is also available. For more information, see Our Locations.

SPs are hired on an as-needed, part-time basis. Considerations for being an SP include:

Candidates must have excellent recall and memory skills.

Acting background may be helpful, but is not necessary.

Hours are flexible. Weekday AM and PM shifts are available, plus some Saturdays.

A meal is provided during the shift.

No invasive procedures will be performed or experimental medications given.

Starting pay is $18 per hour for training and increases to $20 per hour for the first examination day. All SPs are eligible for annual merit-based salary increases, as well as benefits after the requisite period.

Standardized Patient FAQs

How is a DO different from an MD?

Both MDs and Dos are fully qualified physicians licensed to treat patients by doing physical examinations, prescribing medications, ordering tests, and performing surgical and other procedures. However, each type of medical practice has its own philosophy.

A DO practices a “whole person” approach to medicine, which emphasizes learning about the person with the disease and not just the disease itself. Osteopathic medicine also focuses on the neuromusculoskeletal system and its influence on health and how the body’s systems work together for healing. DOs are also taught to emphasize preventing injury or illness, in addition to treating the current medical problem.

A DO receives training in osteopathic manipulative treatment (OMT). Because OMT is part of DO training, it is also an essential part of the COMLEX-USA Level 2-Performance Evaluation clinical skills assessment that the NBOME’s SPs participate in. During training, SPs receive detailed information about OMT and how it specifically relates to the medical case they are portraying.

What does an SP do? Will I be examined just like a real patient?

In your role as an SP, you will be carefully coached to portray an actual medical patient so accurately that the simulation cannot be detected by a skilled clinician—in this case, third- and fourth-year osteopathic medical students. After receiving training about the specific medical case being presented, you will memorize and rehearse the details of the case, which you will simulate for multiple medical students exactly the same way. SPs are assigned cases based on demographics (eg, 45-year-old Caucasian woman, 50-year-old African American man). As an SP, you will undergo the same common examinations that you might have as a real patient in a doctor’s office. For example, the medical students may listen to your heart and lungs with a stethoscope; press on your abdomen to look for tenderness or swelling; look into your eyes, ears, and throat; take your blood pressure; assess your muscle strength; check your reflexes; and check your pulse.

You will NOT have to undergo any invasive procedures, such as breast, genital, pelvic, or rectal exams or corneal reflex tests. None of the examinations will require you to give blood or other samples, and you will not be required to take any drugs. Female SPs may need to shift (but not remove) their bras so that the medical students can listen to their heart. A drape is provided during the physical examination.

Following the exam, you will document the events of the doctor-patient encounter and evaluate the medical student’s interpersonal skills, as you will have been trained to do. You will not give direct feedback to the student on his or her performance.

Is being an SP difficult? What challenges would I face?

This job is not easy, and it is not for everyone. Being an SP is hard work, and it demands a high level of job performance.

Being an SP requires intense concentration while you are being interviewed and examined by the medical students. You must be able to respond exactly as a real patient would, and only as that patient would. You must be able to maintain not only the patient’s character, but also simulate his/her physical condition during the encounter. You must be able to do this many times in succession without any changes.

After the doctor-patient encounter, you must be able to remember and record what the medical student did. You also must be able to respond quickly to feedback from training staff that guide you about improving your job performance.

The attire for an SP is a hospital gown during the examination, and a drape will also be provided. You will be given a robe to wear between encounters or when leaving the examination room. You are required to bring and wear white crew socks and clean, appropriate (non-revealing) undergarments. No T-shirts, tights, or pantyhose are permitted.

Smoking is not permitted in the building, and you must remain in the building throughout your shift, including during meals and other breaks.

What are the qualifications of an effective SP?

At the NBOME, we look for certain qualities in selecting SPs for our program:

Reliability

Superb recall

Ability to follow direction

Ability to think quickly

Flexibility

Fairness

Ability to portray a patient

On the job, we expect SPs to adhere to the following standards:

Accuracy – You must portray the facts of a medical case correctly to ensure each medical student receives fair and equal treatment.

Consistency – Similarly, you must be consistent both with the information you give to each candidate and with the way you give it to ensure each medical student experiences standardization when interviewing and performing the physical examination.

Confidentiality – Your ability to maintain confidentiality and not discuss case information or student doctor performance with other SPs and those outside of the NBOME is essential.

No Conflicts of Interest – Because you will encounter confidential information during the high-stakes examinations at our testing centers, we cannot employ individuals that work at an osteopathic medical school or a test prep center (eg, ETS, Kaplan).

What is the compensation for an SP? Will I receive any benefits?

Starting pay for SPs in training is $18 per hour. Once you have successfully completed the full training and are scheduled for an examination, the rate increases to $20 per hour. All SPs are evaluated annually and are eligible for salary increases based on performance and meeting professional and personal standards throughout the year. SPs are also entitled to benefits after the requisite period. A meal is provided during the shift.

How often do SPs work, and what are the hours?

The work is part-time, as needed. While we do not guarantee a minimum (or maximum) number of hours per week, you will be scheduled to portray your case often enough to remain sharp. You must be available for at least 12 days per month, depending on when exams are administered. If you are repeatedly unavailable, you may be dismissed.

All SPs are expected to work at least some weekends and evenings as needed. Priority is given to applicants that are most regularly available. An online scheduling system is used to schedule shifts. After logging onto the webpage, you can indicate your availability for future examinations and also see what examinations you are currently scheduled to work.

Morning shifts are from 8:00 AM to 3:30 pm, and evening shifts are from 2:00 pm to 9:30 pm. You may arrive 15 minutes before the start of the shift. Lockers are supplied for you to store personal items and clothing. A meal is provided during the shift.

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